Executive Director, Regulatory Affairs - Government ...

Job DescriptionAs the Executive Director of the Government Services Regulatory Affairs team, you will be a vital leader and contributor to the Medicare regulatory and operations agenda of the Government Services Division and broader Pharmacy Benefit Management (PBM) business. You will report directly to the VP of Regulatory Affairs and be responsible for developing and managing the strategic Medicare regulatory agenda for the PBM. You will drive regulatory influencing, interpretation, implementation, and communication of processes required to support the Managed Medicare business within the PBM. This includes, but is not limited to Medicare Part D, Medicare PartB, Medicare Managed Care (MMP demonstrations), Employer Group Waiver Plans (EGWPs) and Retiree Drug Subsidy (RDS).You will be required to manage and influence outcomes associated with large, complex, multi-department partners at all levels of the company. You will have the opportunity to lead cross-functional initiatives within Regulatory Affairs, Government Services, and other business areas as well as partner with others in the industry to drive solutions to regulatory opportunities and challenges identified by our stakeholders. You will be responsible for developing and managing the goals and objectives of the department along with team design and effectiveness. You will also have the responsibility for managing departmental budget and expenses. Responsibilities include:Developing and managing the strategic Medicare Regulatory agenda for the PBM and the health plan and plan sponsors we serve. This will include careful and deliberate analysis of pending legislation, its impact on CVS, our clients and the industry overall. You will be expected to identify both threats and opportunities, mitigate risks to all key stakeholders and identification of resources to help ensure outcomes meet regulatory expectations.Ability to influence outcomes, decisions, priorities, resources, etc., internally across all business areas, and external key stakeholders.Develop and manage a yearly account management strategy with internal and external key constituents designed to help drive viable outcomes for the PBM and the customers we serve. Lead a team of direct and indirect reports (15 - 20 people) who are Medicare Regulatory Subject Matter Experts on all Medicare Matters.Lead and direct teams to deliver solutions that focus on balancing the demands of a highly regulated Medicare environment including health plan contractual obligations, Enterprise Priorities, and customer expectations. You will be the voice of the PBM to industry partners (PCMS, NCPDP, AHIP, etc.) and will work with those partners to help forward the CVS Health PBM agenda. Accountable for all Medicare regulatory deliverables associated with the release of proposed, pending, and final regulations - including the drafting of comments to CMS on proposed regulations and/or RFPs as they relate to the PBM.Designing and managing effectiveness of Medicare regulatory activities, including intuitiveness, timeliness, accuracy, quality, and business partner and health plan satisfaction. Having the unique opportunity to utilize your decision-making skills in the face of uncertainty to determine appropriate course of actions and communicate your decision upward in the organization to ensure municate effectively and succinctly with a diverse range of constituents, both verbally and on paper, with all levels of an organization, both internally and externally that will be paramount to your success. Understanding the complexities of managing regulatory products while balancing the needs of the business with the needs of the customer will help to drive and grow the Medicare Part D business with CVS Health.Pay RangeThe typical pay range for this role is:Minimum: 131,500Maximum: 289,300Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.Required Qualifications10+ years demonstrated strong leadership experience including the design and implementation of strategy for direct and indirect colleague oversight and development.10+ years working in PBM Government Services, Health Plan, Regulatory agencies or other Industry Groups with the ability to leverage people both inside and outside of the organization to effectively influence and build relationshipsProven strategic thinker and influencerCOVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications Advanced Degree Health Care - specifically Medicare and Managed Care Management of large team Working experience in a large matrix organization Microsoft Office Applications Working EST hoursEducation Bachelor's DegreeBusiness OverviewBring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Created: 2026-03-07